You are sitting at your workstation, and it's toward the end of
the day. Over the last several months, you have been noticing a
peculiar pain in your wrists and in part of your hands. Numbness
and tingling sensations are also present. At first, the pain and
numbness went away after a few hours of rest, but now the symptoms
last longer. You start to worry, because now your forearms and elbows
feel very sore, and your neck and shoulders ache. When you go home
to prepare dinner, simple things like using a knife and opening
a jar are suddenly difficult to do.
Carpal
Tunnel Syndrome
If you suffer from these symptoms, there is a good chance
that you have Carpal Tunnel Syndrome (CTS). CTS occurs
when the median nerve, a major nerve of the arm and hand,
is being compressed. This important nerve originates in
the neck, passes underneath the collarbone, travels down
the length of the arm, and into the hand. It is responsible
for sensory and muscle function in the thumb and first
three fingers as well as parts of the forearm.
By
definition, CTS occurs when the median nerve is compressed
as it passes through the carpal tunnel a small space inside
the wrist that also contains the nine flexor tendons of
the forearm. The most common source of compression is
from inflamed, swollen tendon sheaths (coverings) which
can result from repetitive finger-dependent tasks like
typing, mousing, filing, and hard gripping. As the fingers
are moved repetitiously, the tendons slide against one
another and cause "cumulative trauma" and swelling.
THE
NECK -- WRIST CONNECTION
In
many cases of Carpal Tunnel Syndrome, a second source
of compression occurs in the neck where the median nerve
begins! Cervical vertebrae (neck bones) can misalign as
a result of poor posture, bad habits like cradling a phone
with your neck or sleeping on your stomach; and from previous
neck trauma, like for instance, a car accident.
The neck bones can compress the median nerve and produce
symptoms similar to those caused by compression of the
median nerve inside the wrist!
Doctors refer to this condition as a "double lesion
neuropathy," or "double crush syndrome."
Even
if treatment to the wrist successfully removes nerve compression
in that location, symptoms will continue to persist if
nerve compression in the neck remains!
It
is because of this that CTS treatment limited to the wrist
and hand is often insufficient and ineffective.
Many
doctors fail to examine the neck when diagnosing and treating
CTS, and unfortunately, many CTS sufferers don't get the
treatment that they really need!
Standard
medical treatment for CTS typically consists of prescription
pain blockers, anti-inflammatory medication, hand stretches
and exercises, wrist splinting, ultrasound treatment,
and massage. If these methods fail, cortisone injections
to the wrist are usually done to reduce inflammation (does
all of this sound familiar?). By this time, the treating
doctor may order two diagnostic tests: a needle EMG and
a nerve conduction velocity (NCV) test. These are uncomfortable
procedures that measure muscle and nerve function. If
it is determined that the nerve is not functioning properly,
wrist surgery becomes the final option: an incision is
made on the wrist, and the transverse carpal ligament
a band-like ligament directly over the carpal tunnel is
cut in half in an attempt to relieve internal pressure.
This is a risky procedure that oftentimes results in accidental
cutting of adjacent nerves in the hand. Surgery has also
been known to result in scar tissue formation, which can
actually make the condition worse.
So,
knowing this information, what should you do? If you believe
that you are developing carpal tunnel syndrome, you should
seek a doctor who specializes in treating this disorder
and who completely understands how neck problems relate
to CTS. If you have already been diagnosed with CTS and
have been receiving standard medical treatment described
above with no results, you should consult this type of
doctor for a second opinion.
